Health Insurance Enrollment Assister

Choice Consulting is a Collective, Holistic, Outreach, Inclusive, Community Empowerment organization designed to address Social Determinants of Health with evidence-based approaches to service delivery.

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Position Title: Health Insurance Enrollment Assister

Position Summary: The Health Insurance Enrollment Assister will provide fair, impartial, and accurate enrollment assistance and information to individuals and families regarding health insurance options available through the Pennsylvania Health Insurance Marketplace, Pennie. This includes Qualified Health Plans, Medical Assistance (MA) Medicaid, the Children’s Health Insurance Program (CHIP), and Medical Assistance for Workers with Disabilities (MAWD). This position will conduct outreach education and enrollment assistance in a culturally and linguistically appropriate manner to meet the needs of the community served.

The Health Insurance Enrollment Assister will provide accurate enrollment assistance and information to individuals, and families to proactively retain UPMC for You members approaching their Medical Assistance (Medicaid) renewal date, including outreach to UPMC for You households prior to their renewal date. This position will notify members of their upcoming renewal date, educate members on how to renew Medicaid to avoid lapses in coverage, and offer immediate in person and/or phone assistance.

Responsibilities:

· Education and Assistance: Educate and assist individuals who self-identify as uninsured or underinsured in understanding the various health insurance coverage options available to them.

· Enrollment Support: Assess enrollment eligibility and assist in completing initial and renewal applications for Medicaid (Medical Assistance), CHIP, and Pennie. Educate and assist individuals within the household who self-identify as uninsured or underinsured in understanding and applying for Medical Assistance.

· Member Benefits Explanation: Explain the benefits of enrolling children in free to low-cost insurance available through the Commonwealth of Pennsylvania.

· Community Engagement: Cultivate relationships and engage with community-based organizations (CBOs), Federally Qualified Health Centers (FQHCs), and regional provider systems and sites.

· Outreach and Referrals: Facilitate connections and referrals between individuals and community-based agencies to address Social Determinants of Health (SDOH) needs.

· Needs Assessment: Identify and communicate local and regional community-based needs related to SDOH.

· Professional Assistance: Provide courteous, professional, and confidential assistance to all consumers seeking healthcare access and information.

· Resource Role: Serve as a resource for consumers, community-based organizations, and small business owners seeking to understand the Marketplace, health insurance, and healthcare options.

· Marketing and Outreach: Conduct marketing and outreach within local communities about health insurance options through the health insurance marketplace.

· Confidentiality Compliance: Comply with policies on confidential information and applicable laws governing the confidentiality of enrollee financial information, social security numbers, personally identifiable information, and health information, including Medicaid data.

· Follow-Up and Data Entry: Ensure that follow-up and data entry are completed to capture consumer referrals and outcomes.

· Performance Targets: Achieve performance targets, working closely with other CHWs, Enrollment Assisters, and community partners to identify and overcome challenges.

· Continuing Education: Comply with all continuing education and recertification requirements.

• Provide: courteous, professional, and confidential assistance to all consumers seeking healthcare access and information.

Qualifications and Skills:

• Language Skills: Bilingual - English/Spanish is required.
• Minimum work-related experience: Previous experience in the healthcare industry, with a focus on Health Care Policy and Ethics Compliance, Patients’ Rights, Medicaid, and submitting Medicaid applications through COMPASS. Experience with Physical and Behavioral Health Medicaid/Managed Care is also required.

· Preferred education: Bachelor’s Degree or a minimum of 2 to 4 years of work-related Medical Assistance/Medicaid experience.

· Strong interpersonal skills: Effective and strong communication skills, strong interpersonal skills, and the ability to work cooperatively and effectively with other Choice Consulting staff and community-based partners.

· Cultural Competence: Respect for differences in race, ethnicity, age, gender, sexual orientation, gender identity, religion, ability, and socio-economic circumstances; understanding and application of principles of cultural competence.

· Must be able to handle multiple assignments and take initiative to plan and complete projects effectively.

· Team and Independent Work: The ideal candidate will work independently and with a team to determine the best course of action to assist individuals in addressing social determinants of health and other barriers that can affect individuals and families’ ability to live a healthy life. Coordinate with community-based organizations and healthcare providers to coordinate services and support.

· Strong presentation and organizational skills.

· Must have knowledge of and maintain the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA). Ensure the protection and security of personal, confidential, and identifiable information in a professional and responsible manner and carry out all measures to prevent unauthorized disclosures.

· Bilingual proficiency in English and Spanish is required.

Licensure/Certification:

Licensure: Pennie Enrollment Assister License is required. We can assist in obtaining this.

Physical Requirements:

· Must be able to remain in a stationary position 50% of the time.

· Constantly operates a computer and other office machinery such as a calculator, copy machine and printer.

· This position requires frequent communication with customers, community-based organizations, coworkers and members. Must be able to exchange accurate information in these situations by phone and in person.

· The ability to see details at close range.

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This job description is not intended to be a comprehensive listing of all duties and responsibilities that are required of this position. Choice Consulting, LLC job descriptions, and daily responsibilities may change at any time with or without notice.

Job Type: Full-time

Pay: $50,000.00 - $55,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Life insurance
• Paid jury duty
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Evenings as needed
• Monday to Friday
• Weekends as needed

Work Location: In person

Salary : $50,000 - $55,000